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Children’s skeletal systems vary in terms of vascular patterns according to the age and developmental stages. Therefor, the clinical manifestations of osteomyelitis usually differ from one child to another. Children between the ages of 1 year and puberty often experience a sudden onset of symptoms, such as elevated body temperature and systemic signs of toxicity. They may complain swelling, redness, pain, and decreasing ability to bear weight on the affected extremity. Long bones are the most commonly affected areas in children with osteomyelitis, but it may also affect the spine and pelvis (McCance et al., 2010). The clinical manifestations of cellulitis are similar to osteomyelitis, such as swelling, warmth, tenderness, localized pain, and …show more content…
He reported of worsening pain, redness, and swelling in his right ankle due to a basketball injury two weeks before his admission. He developed a fever of 102°F on the following day of his second ankle injury at a trampoline accident. Elevated body temperature, redness, swelling, and tenderness of the affected area are signs of inflammation, which can elevate the WBC counts, CRP, and ESR. The local manifestations of redness, swelling, and pain are caused by the change in vascular permeability and leakage of circulating components into the tissue after a tissue injury. Redness and warmth occur when the bloodflow increases through the site of injury as the fluid accumulates and exerts pressure, which cause swelling and pain at the affected area (McCance et al., 2010). He also reported his decreased ability to bear weight on his right leg. As the literature stated, cellulitis can cause lymphangitic spread, but my patient did not present any visible red lines streaking around the infected …show more content…
According to Pagana and Pagana (2014), the normal range of CRP for children is less than 10.0 mg/L where as my patient’s CRP level was 11.5 mg/L (p. 184). The infections in patient’s right ankle and oral lesions most likely have triggered the liver to produce CRP during an acute inflammatory process. However, a CRP test can only detect the presence of an inflammatory illness, but not the cause or the location of the illness. Compared to ESR, the CRP test is more sensitive and responds more rapidly in an acute inflammatory change. Even though the levels of CRP increase earlier and more intensely during an inflammatory process, they decrease rapidly and return to normal levels before the ESR normalizes when the infection has been resolved (Pagana and Pagana,

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